CTB: Trigger Point Therapy as a Framework for Restoring Pain-Free Movement

Coaching the Body is an approach to therapeutic bodywork that utilizes techniques from traditional Thai massage as a means of efficiently treating trigger points in muscles and restoring normal motion across joints.

Coaching the Body, formerly called Clinical Thai Bodywork, grew out of Chuck Duff‘s frustration with the absence of anatomical knowledge and clinical relevance in traditional Thai massage training. Early in his bodywork career, he attracted clients with serious pain issues, and found that his traditional training had not prepared him to help them. Thai massage training taught him many techniques but not their muscular effects or how to apply them in clinical cases.

Chuck met Claire Davies, author of the Trigger Point Workbook, in 2002 and realized that the Travell & Simons system of myofascial trigger points added a critical missing element for understanding and resolving pain conditions at their origins.

The CTB approach grew out of Chuck’s exhaustive study of trigger point theory and going back and re-analyzing everything he had learned about the traditional poses — a process that took many years.

He immersed himself in studying Travell & Simons, traditional Chinese medicine, osteopathic techniques and fully analyzing the effects and function of each traditional pose he had learned. Chuck taught the first Clinical Thai Bodywork course in 2005, and over the years has continued to evolve his understanding of how to use the traditional techniques in a highly efficient way to accomplish the goal of normal, pain-free movement.

How CTB Differs from Traditional Thai Massage

While CTB uses techniques from traditional Thai massage, CTB is not Thai massage. There are many important differences.

Thai massage is passive on the part of the receiver — known as “lazy man’s yoga”, the work of Thai massage is done with little or no conscious engagement on the part of the client, who may even be in a sleep or deep state of relaxation. While this is fine for general relaxation sessions, we have found that true resolution of serious pain cannot occur without involving the receiver at a conscious level. Some of the ways we engage the client are with breath, muscle activity via contract/relax, reporting of tenderness and other sensation, and most importantly, an experience of conscious, pain-free movement during the session. This is compatible with modern ideas of neuroplasticity and the neuroscience of chronic pain.

CTB practitioners are fully trained to address specific pain issues and are highly competent trigger point therapists. Traditional Thai massage trains practitioners to use their intuition along with standard techniques and sequences, and does not deal with muscles or treatment design for specific issues. Traditional therapists tend to follow standard routines which may be adjusted for specific client complaints, but are not generally competent to reliably and completely address specific clinical issues, nor do they have the clinical language to communicate with other medically oriented practitioners.

We design treatment protocols based on the needs of the client, and avoid putting joints through extreme range until the relevant muscles on both sides of the joint have been treated. Traditional sequences, and in fact predetermined sequences of any kind ignore the specific realities of a given client’s body issues, and often stretch and shorten muscles that have not been touched in the session. Clients with relatively few serious issues can tolerate this approach, but for those with significant dysfunction, it is likely to make things worse. Unfortunately, cyberspace is full of stories of people whose pain was aggravated by overly aggressive traditional Thai massage practitioners going through their “standard routine”.

Our treatment protocols are designed to visit all the muscles that are relevant to a particular regional pain complaint, based upon years of research into direct and satellite referral patterns, functional relationships, perpetuating factors, nervous and vascular impingement and processing of the kinetic chain.

We pay particular attention to shortening muscles, which often block movement through painful dysfunction during shortening. This causes the body to engage the antagonist muscle group to protect the body from pain.

We employ other modalities in conjunction with our work, which may include various forms of heat, electronic point stimulation, PIR and muscle energy techniques.

We view the CTB session as a refined form of trigger point therapy with a strong movement component. We are highly educated trigger point therapists who use Thai techniques. We use compression to treat trigger points and taut fibers, and employ various means of providing feedback to muscles as they change length. This allows us to teach muscles how to lengthen and shorten without the disabling pain response caused by trigger points and dysfunctional muscle spindles.

Traditional Thai training involves little or no anatomy, because this was not the basis of the traditional medicine. Some schools today provide rudimentary anatomy exposure that is poorly integrated into the rest of the training, if at all. We are successful only because we fully understand muscular anatomy and function. Our practitioners have a deep understanding of functional anatomy, and all of our classes build and employ this knowledge. We don’t abandon the energetic viewpoint of traditional bodywork, but add a great deal of clinical knowledge to it.

The focus of CTB is the restoration of normal, pain-free movement. The techniques combine compression of tender points, traversal of key lines and joint movement to find and eliminate taut fibers and tenderness and to unlock the compensatory splinting patterns that are the body’s attempt to stabilize painful and unstable areas.

We use the poses in a specific way to achieve muscular effects, and to provide a conscious experience of normal movement.

Our goal is not to replace or invalidate the energetic aspect of healing – we retain the energetic and intuitive components, and add clinical knowledge as an additional layer.

Experience CTB at the Thai Bodywork Clinic

Studies have shown that over 80% of pain complaints presented at clinics are likely to be caused by myofascial trigger points rather than actual tissue damage. Unfortunately, most practitioners tend to interpret pain as a symptom of an injury, leading to ineffective, side-effect-laden treatment approaches like drugs, steroid injections and surgery.

CTB has a high rate of success with even very serious pain across a wide variety of diagnoses. Our clinic provides affordable 90-minute student treatments as well as apprentice and professional Clinical Thai Bodywork sessions.